A nursing student needs to have a PPD prior to beginning nursing school. Seventy-two hours after the PPD is administered the student develops a reddened urticarial wheal. What is the reaction of her skin related to?
A) Leukotrienes initiating inflammatory responses
B) Bradykinin, a polypeptide that can increase vascular permeability
C) Prostaglandins produce smooth muscle contraction
D) Mediated by sensitized T cells and macrophages
Ans: D
Feedback: Type IV, also known as cellular hypersensitivity, occurs 24 to 72 hours after exposure to an allergen. It is mediated by sensitized T cells and macrophages. Prostaglandins are composed of unsaturated fatty acids, and produced smooth muscle contraction as well as vasodialation and increased capillary permeability. Leukotrienes are chemical mediators that initiate the inflammatory response causing smooth muscle contraction, bronchial constriction, and mucous secretion in the airways. Bradykinin is a polypeptide with the ability to cause increased vascular permeability, vasodilation, hypotension, and contraction of many types of smooth muscle, such as bronchi.
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